DEPARTMENT OF INSURANCE
Affiliations
NameSelfridge & Associates Inc.DOIID399957NAIC NPN3319510
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
InactiveNon ResidentAgentPrepaid Dental Plan10/30/19963/31/1997 
InactiveNon ResidentAgentHealth12/14/19923/31/2020 
InactiveNon ResidentAgentLife12/14/19923/31/2020 
InactiveNon ResidentAgentProperty12/18/20003/31/2020 
InactiveNon ResidentAgentCasualty12/18/20003/31/2020 
InactiveNon ResidentAgentHealth Maintenance Organization11/12/19913/1/2001 
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.
Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveAIG Assurance Company300897Agent - Casualty3/29/20057/24/2010
InactiveAIG Assurance Company300897Agent - Property3/29/20057/24/2010
InactiveAmerican Economy Insurance Company300315Agent - Casualty11/9/20193/31/2020
InactiveAmerican Economy Insurance Company300315Agent - Property11/9/20193/31/2020
InactiveAmerican Family Life Assurance Company of Columbus (AFLAC)301781Agent - Health12/8/20062/11/2020
InactiveAmerican Family Life Assurance Company of Columbus (AFLAC)301781Agent - Life12/8/20062/11/2020
InactiveAmerican United Life Insurance Company300498Agent - Health4/1/20033/31/2020
InactiveAmerican United Life Insurance Company300498Agent - Life4/1/20033/31/2020
InactiveAnthem Health Plans of Kentucky, Inc.300999Agent - Health3/1/200112/1/2014
InactiveAnthem Health Plans of Kentucky, Inc.300999Agent - Health Maintenance Organization11/12/19913/1/2001
InactiveAnthem Insurance Companies, Inc.300941Agent - Health1/22/200210/16/2012
InactiveAnthem Life Insurance Company301209Agent - Health5/20/199912/1/2014
InactiveAnthem Life Insurance Company301209Agent - Life5/20/199912/1/2014
InactiveAuto-Owners Insurance Company301480Agent - Casualty9/27/201812/16/2019
InactiveAuto-Owners Insurance Company301480Agent - Property9/27/201812/16/2019
InactiveAutomobile Insurance Company of Hartford, Connecticut300630Agent - Casualty12/17/20035/19/2020
InactiveAutomobile Insurance Company of Hartford, Connecticut300630Agent - Property12/17/20035/19/2020
InactiveBanner Life Insurance Company301696Agent - Life8/2/20173/31/2020
InactiveBerkshire Life Insurance Company of America300983Agent - Health2/26/20039/16/2013
InactiveBerkshire Life Insurance Company of America300983Agent - Life2/26/20039/16/2013
InactiveBristol West Insurance Company301655Agent - Casualty12/1/200912/7/2017
InactiveBristol West Insurance Company301655Agent - Property12/1/200912/7/2017
InactiveCharter Oak Fire Insurance Company (The)301501Agent - Casualty7/26/200612/9/2009
InactiveCharter Oak Fire Insurance Company (The)301501Agent - Property7/26/200612/9/2009
InactiveCincinnati Insurance Company301298Agent - Casualty9/4/20083/12/2010
InactiveCincinnati Insurance Company301298Agent - Property9/4/20083/12/2010
InactiveCompBenefits Dental, Inc.591692Agent - Health6/18/20087/6/2012
InactiveCompBenefits Insurance Company301864Agent - Health6/18/20087/6/2012
InactiveCompBenefits Insurance Company301864Agent - Life6/18/20087/6/2012
InactiveCompDent Corporation301387Agent - Prepaid Dental Plan10/30/19963/31/1997
InactiveDental Concern Inc. (The)301641Agent - Health6/17/20027/6/2012
InactiveFarmington Casualty Company301137Agent - Casualty7/26/200612/9/2009
InactiveFarmington Casualty Company301137Agent - Property7/26/200612/9/2009
InactiveForemost Insurance Company Grand Rapids, Michigan301027Agent - Casualty7/7/20043/31/2020
InactiveForemost Insurance Company Grand Rapids, Michigan301027Agent - Property7/7/20043/31/2020
InactiveGeneral American Life Insurance Company300280Agent - Health7/23/19935/19/1999
InactiveGeneral American Life Insurance Company300280Agent - Life7/23/19935/19/1999
InactiveGeneral Casualty Company of Wisconsin300930Agent - Casualty7/13/20183/31/2020
InactiveGeneral Casualty Company of Wisconsin300930Agent - Property7/13/20183/31/2020
InactiveGolden Rule Insurance Company301943Agent - Health12/14/199211/22/2000
InactiveGolden Rule Insurance Company301943Agent - Life12/14/199211/22/2000
InactiveGranite State Insurance Company300818Agent - Casualty6/29/20057/24/2010
InactiveGranite State Insurance Company300818Agent - Property6/29/20057/24/2010
InactiveGuardian Life Insurance Company of America301316Agent - Health2/26/20033/31/2020
InactiveGuardian Life Insurance Company of America301316Agent - Life2/26/20033/31/2020
InactiveHallmark National Insurance Company300494Agent - Casualty4/19/200512/31/2009
InactiveHallmark National Insurance Company300494Agent - Property4/19/200512/31/2009
InactiveHartford Accident and Indemnity Company301917Agent - Casualty3/16/20063/31/2020
InactiveHartford Accident and Indemnity Company301917Agent - Property3/16/20063/31/2020
InactiveHartford Casualty Insurance Company301332Agent - Casualty3/16/20063/31/2020
InactiveHartford Casualty Insurance Company301332Agent - Property3/16/20063/31/2020
InactiveHartford Fire Insurance Company300628Agent - Casualty3/16/20063/31/2020
InactiveHartford Fire Insurance Company300628Agent - Property3/16/20063/31/2020
InactiveHartford Insurance Company of the Midwest301918Agent - Casualty3/16/20063/31/2020
InactiveHartford Insurance Company of the Midwest301918Agent - Property3/16/20063/31/2020
InactiveHartford Underwriters Insurance Company301064Agent - Casualty3/16/20063/31/2020
InactiveHartford Underwriters Insurance Company301064Agent - Property3/16/20063/31/2020
InactiveHumana Health Plan, Inc.300142Agent - Health3/1/20017/6/2012
InactiveHumana Health Plan, Inc.300142Agent - Health Maintenance Organization2/1/19933/1/2001
InactiveHumana Insurance Company301104Agent - Health10/10/20017/6/2012
InactiveHumana Insurance Company301104Agent - Life10/10/20017/6/2012
InactiveHumana Insurance Company of Kentucky300826Agent - Health9/10/20077/6/2012
InactiveHumana Insurance Company of Kentucky300826Agent - Life9/10/20077/6/2012
InactiveHumanaDental Insurance Company301457Agent - Health10/18/20012/23/2012
InactiveIllinois National Insurance Company301367Agent - Casualty1/8/20077/24/2010
InactiveIllinois National Insurance Company301367Agent - Property1/8/20077/24/2010
InactiveJohn Hancock Life Insurance Company300821Agent - Health4/25/200312/30/2009
InactiveJohn Hancock Life Insurance Company300821Agent - Life4/25/200312/30/2009
InactiveJohn Hancock Life Insurance Company (U.S.A.)300132Agent - Health9/19/20083/31/2020
InactiveJohn Hancock Life Insurance Company (U.S.A.)300132Agent - Life9/19/20083/31/2020
InactiveJohn Hancock Variable Life Insurance Company301914Agent - Life5/2/20032/24/2009
InactiveKanawha Insurance Company300127Agent - Health6/18/20087/6/2012
InactiveKanawha Insurance Company300127Agent - Life6/18/20087/6/2012
InactiveMidland National Life Insurance Company300923Agent - Health6/11/19983/27/2000
InactiveMidland National Life Insurance Company300923Agent - Life6/11/19983/27/2000
InactiveMonroe Guaranty Insurance Company300771Agent - Casualty11/15/200212/19/2005
InactiveMonroe Guaranty Insurance Company300771Agent - Property11/15/200212/19/2005
InactiveOhio Farmers Insurance Company301667Agent - Casualty12/18/20006/20/2003
InactiveOhio Farmers Insurance Company301667Agent - Property12/18/20006/20/2003
InactiveOwners Insurance Company300796Agent - Casualty10/2/201812/16/2019
InactiveOwners Insurance Company300796Agent - Property10/2/201812/16/2019
InactivePlymouth Rock Assurance Preferred Corporation301834Agent - Casualty9/10/20077/24/2010
InactivePlymouth Rock Assurance Preferred Corporation301834Agent - Property9/10/20077/24/2010
InactivePrincipal Life Insurance Company300129Agent - Health11/6/199612/14/2009
InactivePrincipal Life Insurance Company300129Agent - Life11/6/199612/14/2009
InactiveProgressive Casualty Insurance Company300696Agent - Casualty12/17/201311/10/2016
InactiveProgressive Casualty Insurance Company300696Agent - Property12/17/201311/10/2016
InactiveProtective Life Insurance Company300638Agent - Health10/31/20143/31/2020
InactiveProtective Life Insurance Company300638Agent - Life10/31/20143/31/2020
InactiveReassure America Life Insurance Company301902Agent - Health11/2/19951/2/2003
InactiveReassure America Life Insurance Company301902Agent - Life11/2/19951/2/2003
InactiveSAFECO Insurance Company of America300159Agent - Casualty3/5/20153/31/2020
InactiveSAFECO Insurance Company of America300159Agent - Property3/5/20153/31/2020
InactiveSAFECO Insurance Company of Illinois301350Agent - Casualty3/5/20153/31/2020
InactiveSAFECO Insurance Company of Illinois301350Agent - Property3/5/20153/31/2020
InactiveSelective Insurance Company of America500018Agent - Casualty3/6/20073/6/2020
InactiveSelective Insurance Company of America500018Agent - Property3/6/20073/6/2020
InactiveSelective Insurance Company of South Carolina500012Agent - Casualty3/6/20073/6/2020
InactiveSelective Insurance Company of South Carolina500012Agent - Property3/6/20073/6/2020
InactiveSelective Insurance Company of the Southeast300381Agent - Casualty3/6/20073/6/2020
InactiveSelective Insurance Company of the Southeast300381Agent - Property3/6/20073/6/2020
InactiveSentinel Insurance Company, Limited501696Agent - Casualty3/16/20063/31/2020
InactiveSentinel Insurance Company, Limited501696Agent - Property3/16/20063/31/2020
InactiveStandard Fire Insurance Company (The)301068Agent - Casualty12/17/20035/19/2020
InactiveStandard Fire Insurance Company (The)301068Agent - Property12/17/20035/19/2020
InactiveStandard Insurance Company300185Agent - Health11/24/200412/31/2013
InactiveStandard Insurance Company300185Agent - Life11/24/200412/31/2013
InactiveState Auto Property & Casualty Insurance Company301953Agent - Casualty4/19/200512/31/2009
InactiveState Auto Property & Casualty Insurance Company301953Agent - Property4/19/200512/31/2009
InactiveState Automobile Mutual Insurance Company301824Agent - Casualty4/19/200512/31/2009
InactiveState Automobile Mutual Insurance Company301824Agent - Property4/19/200512/31/2009
InactiveThe Phoenix Insurance Company301502Agent - Casualty12/17/20035/19/2020
InactiveThe Phoenix Insurance Company301502Agent - Property12/17/20035/19/2020
InactiveTime Insurance Company300683Agent - Health1/29/200412/15/2004
InactiveTime Insurance Company300683Agent - Life1/29/200412/15/2004
InactiveTravCo Insurance Company301828Agent - Casualty12/17/200312/5/2013
InactiveTravCo Insurance Company301828Agent - Property12/17/200312/5/2013
InactiveTravelers Casualty Company of Connecticut301505Agent - Casualty12/17/200312/9/2009
InactiveTravelers Casualty Company of Connecticut301505Agent - Property12/17/200312/9/2009
InactiveTravelers Casualty Insurance Company of America300522Agent - Casualty7/26/200612/3/2014
InactiveTravelers Casualty Insurance Company of America300522Agent - Property7/26/200612/3/2014
InactiveTravelers Casualty and Surety Company301067Agent - Casualty7/26/200612/9/2009
InactiveTravelers Casualty and Surety Company301067Agent - Property7/26/200612/9/2009
InactiveTravelers Commercial Casualty Company301695Agent - Casualty7/26/200612/9/2009
InactiveTravelers Commercial Casualty Company301695Agent - Property7/26/200612/9/2009
InactiveTravelers Commercial Insurance Company301506Agent - Casualty8/1/200612/9/2009
InactiveTravelers Commercial Insurance Company301506Agent - Property8/1/200612/9/2009
InactiveTravelers Home and Marine Insurance Company (The)301802Agent - Casualty8/1/20065/19/2020
InactiveTravelers Home and Marine Insurance Company (The)301802Agent - Property8/1/20065/19/2020
InactiveTravelers Indemnity Company (The)301855Agent - Casualty7/26/200612/9/2009
InactiveTravelers Indemnity Company (The)301855Agent - Property7/26/200612/9/2009
InactiveTravelers Indemnity Company of America (The)301093Agent - Casualty12/17/200312/9/2009
InactiveTravelers Indemnity Company of America (The)301093Agent - Property12/17/200312/9/2009
InactiveTravelers Indemnity Company of Connecticut (The)301591Agent - Casualty9/2/201112/3/2014
InactiveTravelers Indemnity Company of Connecticut (The)301591Agent - Property9/2/201112/3/2014
InactiveTravelers Personal Insurance Company705785Agent - Casualty3/16/20205/19/2020
InactiveTravelers Personal Insurance Company705785Agent - Property3/16/20205/19/2020
InactiveTravelers Property Casualty Company of America301649Agent - Casualty7/26/200612/9/2009
InactiveTravelers Property Casualty Company of America301649Agent - Property7/26/200612/9/2009
InactiveTravelers Property Casualty Insurance Company301508Agent - Casualty12/17/200312/9/2009
InactiveTravelers Property Casualty Insurance Company301508Agent - Property12/17/200312/9/2009
InactiveTwin City Fire Insurance Company300721Agent - Casualty3/16/20063/31/2020
InactiveTwin City Fire Insurance Company300721Agent - Property3/16/20063/31/2020
InactiveUnion Security Insurance Company301844Agent - Health2/25/19991/9/2015
InactiveUnion Security Insurance Company301844Agent - Life2/25/19991/9/2015
InactiveUnited Financial Casualty Company301886Agent - Casualty12/17/201311/10/2016
InactiveUnited Financial Casualty Company301886Agent - Property12/17/201311/10/2016
InactiveUnitedHealthcare Insurance Company300946Agent - Health8/21/200011/30/2016
InactiveUnitedHealthcare Insurance Company300946Agent - Life8/21/200011/30/2016
InactiveUnitedHealthcare of Kentucky, Ltd.301337Agent - Health3/1/200111/30/2016
InactiveUnitedHealthcare of Kentucky, Ltd.301337Agent - Health Maintenance Organization7/17/20003/1/2001
InactiveUnitedHealthcare of Ohio, Inc.300493Agent - Health9/19/201411/30/2016
InactiveWestern Surety Company300283Agent - Casualty4/15/20023/6/2020
InactiveWestfield Insurance Company301950Agent - Casualty12/18/20006/20/2003
InactiveWestfield Insurance Company301950Agent - Property12/18/20006/20/2003
InactiveWestfield National Insurance Company301036Agent - Casualty1/11/20016/20/2003
InactiveWestfield National Insurance Company301036Agent - Property1/11/20016/20/2003
InactiveWilcac Life Insurance Company301573Agent - Health11/2/19953/31/1997
InactiveWilcac Life Insurance Company301573Agent - Life11/2/19953/31/1997
Inactive300277Agent - Life7/12/20051/1/2007
Designated Individuals
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveArison Insurance Services, Inc.401001Agent - Health4/7/199912/31/2001
InactiveArison Insurance Services, Inc.401001Agent - Life4/7/199912/31/2001
InactiveBetz, David Charles 358948Agent - Health2/29/19962/24/2003
InactiveBetz, David Charles 358948Agent - Life2/29/19962/24/2003
InactiveLete, Zary F 371141Agent - Casualty8/15/20005/31/2007
InactiveLete, Zary F 371141Agent - Property8/15/20005/31/2007
InactiveMedlink Inc400721Agent - Health11/23/199812/31/2001
InactiveMedlink Inc400721Agent - Life11/23/199812/31/2001
InactiveMegraw, Keith J 357616Agent - Health11/12/19912/24/2003
InactiveMegraw, Keith J 357616Agent - Health Maintenance Organization11/12/19913/1/2001
InactiveMegraw, Keith J 357616Agent - Life11/12/19912/24/2003
InactiveSelfridge, Gary William 320985Agent - Casualty8/15/20003/31/2020
InactiveSelfridge, Gary William 320985Agent - Health11/12/19913/31/2020
InactiveSelfridge, Gary William 320985Agent - Life11/12/19913/31/2020
InactiveSelfridge, Gary William 320985Agent - Property8/15/20003/31/2020

© Commonwealth of Kentucky. All rights reserved.